Stigma and discrimination - challenges to development

Dr Glenda P. Simms, Contributor

In November 2010, UNAIDS released its report on the global AIDS epidemic. This very important and eye-opening report has provided the needed information for every nation to revise and reaffirm the world's commitment to conquering the scourge of the HIV/AIDS pandemic.

The report highlighted the following concerns which were addressed by significant numbers of the nation states that report periodically on a number of human-rights issues to the United Nations.

1. Stigma and discrimination in health-care systems continue to adversely affect access and provision of services to citizens who are either vulnerable to or affected by HIV.
   
2. It was noted that in Central and South America, some health-care deliverers are likely to deny services to high-risk population groups such as sex workers and men who have sex with men. This situation is also relevant to African societies such as Lesotho, Mozambique and Senegal, where stigma and discrimination continue to be barriers to citizens who need a range of health-care services including HIV testing and treatment.
   
3. The United Nations-designated organisations responsible for monitoring the HIV/AIDS pandemic also hear horrendous stories of violence against and murder of individuals who are suspected of homosexual orientation and practice.
   
4. The continuing global culture of intolerance, stigma and discrimination calls for all nation states to involve persons living with HIV and those who are identified as most vulnerable in all national efforts to fight the disease. The 2010 Global Report has noted that 96 per cent of countries which contributed to the information that is highlighted involve people living with HIV in meaningful ways in their country policies.

The report also highlighted the negative effects of punitive legislation and policies on the ability of persons with HIV or those who fall in vulnerable groups to access HIV-prevention programmes, treatment, appropriate care and access to all services that would guarantee their dignity and inherent human rights. Some of these laws are very explicit in many parts of the world. In some societies, same-sex consensual relations are criminalised; in others, homosexuals run the risk of getting the death penalty for having sex with a same-sex partner. Furthermore, some societies restrict or prevent the entrance across their borders of individuals who are HIV-positive.

Another vulnerable group that is affected by punitive legislation is sex workers.

Fossilised legislation

While it is a fact that more and more countries have been systematically removing such fossilised legislation, there is still a concern that without mechanisms to record, document and address cases of discrimination experienced by people living with or vulnerable to HIV, the stated problems will still remain. In fact, the global review has revealed that support systems such as legal-aid services are more available in First World or high-income countries, while the lower middle-income and the poorest societies continue to lag behind in the access to services, even when the discriminatory legislative framework is cleaned up.

In the ongoing global discourse on the HIV/AIDS pandemic, the issue of gender equality has been finally placed on the front burner. This focus is in line with the achievement of many of the Millennium Development Goals. In particular, it is a challenge to nation states to demonstrate the progress towards the achievements of gender equality and the empowerment of women.

The 2010 UNAIDS Global Report reminds us that gender relationships and the response to HIV/AIDS differ from region to region and from country to country. However, in spite of these variations, the following realities must be addressed in every nation state:

1. Power imbalances between men and women at all levels of society.
   
2. Harmful gender norms which have been ingrained in both the private and public spheres.
   
3. The relationship between the spread of HIV and gender-based violence.
   
4. The impact of poverty on women and their children.
   
5. The marginalisation of women in the political process.
   
6. The need for greater access to education for both girls and boys.

In an effort to demonstrate the urgent need for gender equality as a plank of development, the report forcibly stated that "in nearly all countries in sub-Saharan Africa and certain Caribbean countries, the majority of people living with HIV are women, especially girls and women aged 15-24 years".

In 2010, the local UNAIDS office convened a stakeholder meeting in order to identify the linkages between the global concerns about the HIV/AIDS pandemic and the local vision for change in the Jamaican situation. This interactive and spirited meeting agreed on the need for a holistic approach to the pandemic. The participants underlined the need for the Jamaican Government and the various non-governmental organisations (NGOs) that are partnering to make a difference at the levels of the individual, the family and the community.

These stakeholders came to the conclusion that even though the data show that in Jamaica and the Caribbean the epidemic is declining, the reality is that the gains are fragile. The following priorities were, therefore, identified for the approaches in 2011.

1. A holistic approach that integrates a gendered analysis in all HIV programme is an immediate necessity.
   
2. A partnership framework must be identified if the pandemic is to be effectively managed.
   
3. Leaders of government agencies and NGOs must be held accountable in all HIV/AIDS initiative.
   
4. Stigma and discrimination must be addressed in clear and non-ambiguous terms by both government and non-government actors.

All laws that impinge on the human rights of any sector of the Jamaican society must be repealed in a framework that respects the inherent human rights and dignity of every citizen.

In line with these discussions, the issue of the HIV/AIDS pandemic should be seen as a prime-time issue for Jamaica in 2011.

Dr Glenda P. Simms is a gender expert and consultant. Email feedback to columns@gleanerjm.com.